All-In with Chamath, Jason, Sacks & Friedberg Supercharging a New FDA: Marty Makary on Science, Power & Patients
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Jan 15, 2026 
Marty Makary, a surgeon and public health researcher, shares his insights as the current FDA Commissioner, focusing on healthcare reforms and price transparency. He discusses 42 swift reforms at the FDA, the U.S.-China biotech race, and how to accelerate drug approvals safely. Makary also critiques outdated nutrition guidelines, advocating for a revamped Food Pyramid and addressing America’s obesity crisis with GLP-1 drugs. He delves into vaccine strategies, the importance of AI in healthcare, and explores rising autism rates and their potential causes.
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Agency Modernization Cuts Red Tape
- The FDA will challenge long-standing assumptions and run 42 major reforms in ten months.
- Marty Makary says modernizing workflows and transparency can compress drug timelines drastically.
Speed Phase One With Centralized Processes
- Centralize IRBs and streamline hospital contracting to speed phase one trials.
- Use AI to cut administrative IND processing from 60 days to one day to stay competitive with China.
One Good Trial And Less Animal Testing
- FDA will allow one well-designed pivotal trial instead of two as the default, saving time and money.
- The agency will reduce animal testing and accept modern alternatives like organ-on-chip and computational models.
